| NPI | 1649822768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 29N00000X) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 103858) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2025-06-26 |